Internal and Emergency Medicine

, Volume 8, Issue 1, pp 75–82

The effect of body mass index on intubation success rates and complications during emergency airway management

Authors

    • Department of Medicine, Division of Pulmonary-Critical Care MedicineLahey Clinic Medical Center
  • Lillian L. Emlet
    • Department of Critical Care MedicineUniversity of Pittsburgh Medical Center
  • Frank X. Guyette
    • Department of Emergency MedicineUniversity of Pittsburgh Medical Center
EM - AIRWAY FORUM

DOI: 10.1007/s11739-012-0874-x

Cite this article as:
Dargin, J.M., Emlet, L.L. & Guyette, F.X. Intern Emerg Med (2013) 8: 75. doi:10.1007/s11739-012-0874-x

Abstract

We evaluated the effect of body mass index (BMI) on intubation success rates and complications during emergency airway management. We retrospectively analyzed an airway registry at an academic medical center. The primary outcomes were the incidence of difficult intubation and complication rates, stratified by BMI. We captured 1,075 (98 %, 1,075/1,102; 95 % CI 97–99) intubations. Four hundred twenty-six patients (40 %) had a normal BMI, 289 (27 %) were overweight, 261 (25 %) were obese, and 77 (7 %) were morbidly obese. In a multivariate analysis, obesity (OR 1.90; 95 % CI 1.04–3.45; p = 0.04), but not morbid obesity (OR 2.18; 95 % CI 0.95–4.99; p = 0.07), predicted difficult intubation. BMI was not predictive of post-intubation complications. Airway management in the morbidly obese differed when compared with lean patients, with less use of rapid sequence intubation and increased use of fiberoptic bronchoscopy in the former. During emergency airway management, difficult intubation is more common in obese patients, and morbidly obese patients are more commonly treated as potentially difficult airways.

Keywords

ObesityBody mass indexAirwayIntubationEndotrachealEmergency

Copyright information

© SIMI 2012